Horror Stories(?) About Korean OBGYN Clinics

(“Pretend not to know”, “Pretend not to go”, “Pretend it’s the first time”. Push! Push! {1997}. Source)

This was the most read society news story on Naver last week, undoubtedly because of the recent announcement that the pill is to be made prescription only (a similar article was #5), which will naturally require more visits to OBGYNs. I have my own article about that coming out in Busan Haps next month (update: here it is!), but in the meantime see here, here and here for further details, as well as Korean Gender Reader posts from June.

Without discounting the genuine negative experiences outlined below, for the sake of balance let add that my wife has had no problems with those OBGYNs she’s dealt with since her first pregnancy, nor this 19 year-old student who wrote about her first visit to a clinic for her university newspaper (although it’s true she was given some strange and/or unnecessary tests). Also, it seems somewhat naive of patients to be surprised at questions about their sexual experience, and a little churlish of them to complain about them.

Update — in addition to many helpful, practical reader comments on this post below, and on the previous one about the student’s visit, let me recommend this one by a friend on Facebook:

…to be honest, I think most women expect a trip to the gyno to be awkward, that’s par for the course. However, many of the questions mentioned in the article were definitely way out of line. I’ve come across some less than sensitive (aka prejudiced and or judgmental) docs here.. I just assumed their overly-direct statements/questions were just a translation issue. Obviously not!

One disheartening aspect of women’s clinics is that you have to speak to a nurse (or sometimes just the receptionist) first, often in crowded reception area, to explain why you’re there. They often ask for all your symptoms, check your weight and blood pressure and when you had your last period in front of countless strangers. One clinic I went to had an LCD screen with the waiting patients listed in order of their turn.. including the reason why there were there… So much for privacy! It just adds another layer of humiliation to an already uncomfortable situation.

That being said- there are some amazing gynos here. I hope these problems can be properly addressed- no one should have to feel ashamed in front of their doctor. The danger here is that women will stop seeing doctors about their gynecological/sexual health out of fear of embarrassment and risk greater health problems.

“성경험 유무는 왜…? 굳이 그것까지” 굴욕의 진료, 산부인과

“Why do they ask about sexual experience? Is that really necessary?” Humiliating Treatment at OBGYN Clinics

엄지원 / Uhm Ji-won, The Hankyoreh, 2 July 2012

여성이 불편한 산부인과 / Women find gynecology clinics uncomfortable
접수대부터 진료·시술까지 / From reception to treatment and surgery
의료진 노골적 발언에 민망 / OBGYNs make suggestive, embarrassing comments
사전피임약 처방전 필요한데… / The pill requires a prescription…
여성들 심리적 부담 커 고민 / Psychological pressure on women increases
환자 배려 의료지침 등 필요 / OBGYNs need guidance on bedside manners

지난 6월 정부는 사전피임약을 전문약으로 분류하는 약사법 개정안을 발표했다. 이 법안이 국회에서 통과되면 여성들이 산부인과를 찾을 일이 더 많아질 수 있다. 이를 두고 여성들은 산부인과에 가는 것 자체가 눈치 보이는 사회 분위기를 지적한 바 있다.

This June, the government announced that it was considering amending the Drugs, Cosmetics, and Medical Instruments Law to reclassify the pill as a prescription medicine. If passed by Congress, it will mean women will have to visit OBGYN clinics much more often. In light of this, women have been pointing out the [bad] atmosphere at them.

한국여성민 우회가 산부인과 진료 경험이 있는 여성 210명을 상대로 설문조사한 결과는 ‘외부의 시선’ 못지않게 산부인과 진료 자체에 대한 여성들의 두려움이 실제로 광범위하게 퍼져 있다는 사실을 확인해준다. 설문 특성상 응답자의 신상과 구체적인 피해 일시·장소 등을 밝히진 않았지만, 여성들은 산부인과에서 겪은 수치와 불편을 설문지에 빼곡히 적었다.

Korean Womenlink conducted a survey of 210 women who had received treatment at OBGYN clinics, and the results confirmed not just the endurance of public stereotypes that all women visiting OBGYN clinics had STDs, but also that women’s fears in visiting them were well-founded. The survey was anonymous, and respondents were asked to provide no details of the times or places in which they’d been made to feel embarrassed or humiliated, but many still felt compelled to write a great deal about their negative experiences.

(Source)

신지은(가명·36)씨는 얼마 전 산부인과에서 느낀 굴욕감이 생생하다. 아이를 낳고 정기검진차 방문한 신씨에게 의사는 은근히 ‘수술’을 권했다.

Shin Ji-eun (not her real name), 36, vividly remembers visiting a clinic for a regular check-up after her child was born, where the doctor implied she should have surgery:

“출산을 한 뒤니 부부관계를 오래 유지하고 싶으면 이참에 수술을 하라”고 말했다. 그가 권한 것은 여성 성기를 성형하는 수술이었다. “배려인지 희롱인지 알 수 없는 제안”이었다고 신씨는 말했다.

“After having a baby, and seeing as you’re already here, you should have surgery on your genitals for the sake of your married life”, the doctor said [James - what kind of surgery isn’t specified]. “I didn’t know whether to take it as a joke or a serious suggestion” Ji-eun said.

실제로 설문조사에 응한 여성들은 진료가 시작되는 접수대에서부터 낙태경험 또는 성경험을 묻는 수치스런 질문을 받았다고 증언했다. 어느 여성은 “진료 접수 때 ‘냉이 많아져서 병원에 왔다’고 했더니, 접수대 간호사가 큰 소리로 ‘성병이네요’라고 말해 매우 불쾌했다”고 적었다.

Respondents to the survey reported being asked embarrassing questions about their sexual experience and having abortions even as soon as arriving at the reception desk. One woman said “I went to the OBGYN clinic because I was having a heavy vaginal discharge, and the nurse at the desk loudly said ‘Oh, you must have an STD!’, which mortified me.”

진료 시작 뒤에도 수치심을 주는 의료진의 발언이 이어졌다고 응답자들은 적었다. 특히 “성경험이 있느냐”고 묻는 의료진의 태도가 당혹스러웠다고 여성들은 밝혔다. 어느 여성은 “성경험이 없다”고 답했다가 “검사할 때 번거롭다. 솔직히 말하라”는 의사의 말을 들었다. “그 뒤로 가급적 산부인과에 가지 않는다”고 이 여성은 밝혔다.

The shaming experiences continue after treatment starts too, because of doctors’ comments. In particular, after being asked if she had sexual experience, and replying that she didn’t, one woman found her doctor’s reply – “Be honest. Otherwise the examination will be more complicated” – perplexing, and said she’d rather not visit an OBGYN again.

(Source)

의료진이 성경험 여부를 묻는 것은 관련 진료에 필수적인 정보이기 때문이다. 그러나 성경험이 있든 없든 “왜 그런 정보가 필요한지 사전 설명 없이 다짜고짜 물어 불쾌했다”는 게 처음 산부인과를 방문한 여성들의 이구동성이다. 여성민우회 조사를 보면, 산부인과 방문 당시 성경험이 있었던 경우는 69.5％, 없었던 경우는 29.5％였다.

Before being treated, patients need an explanation of why being asked about their sexual experience was necessary. Without that, many women reported, they felt very embarrassed on their first visits to clinics.

Of the respondents, 69.5% had prior sexual experience, and 29.5% didn’t.

Top Left — Of 210 Respondents: 35.2% had no negative experiences, 64.3% did, and 0.5% didn’t reply.

Top Right — Of the 64.3% of women who reported negative experiences: 56.3% were related to fears and anxieties about their treatment; 30.4% to public perceptions [of OBGYN patients]; 3.7%  to questions about STDs; 3.0% to costs of treatment; and 6.7% to other things.

Bottom — Age at first visit to an OBGYN

자궁경부암 검사를 받으러 갔던 어느 여성은 “결혼 안 했으면 처녀막이 상할 수 있으니 검사하지 말라”는 의사의 말을 들었다. 자신을 배려하는 듯하면서도 ‘처녀성’ 운운하는 발언에 수치심을 느꼈다고 응답자는 적었다. “몇번 경험해봤나”, “최근엔 언제였나”, “첫 경험이 언제인가”, “남자친구 말고 섹스 파트너가 있나” 등을 아무렇지 않게 묻는 일은 점잖은 축에 속했다. 이들이 기록한 의료진의 어떤 발언은 그대로 옮기기에 민망할 정도다.

One woman who visited in order to be examined for cervical cancer was asked if she was married, “because if you haven’t, then you shouldn’t receive an examination that will break your hymen”; while possibly the doctor was just being considerate about her virginity, the woman still felt ashamed and embarrassed. Other embarrassing questions, like “How many times have you had sex?”; “When was the last time you had sex?”; “When did you lose your virginity?”; and “Do you have another partner in addition to your boyfriend”, don’t even begin to compare to what some doctors asked patients, which they reported were too shameful to write down in their surveys (source, right).

“성기 모양이 참 예쁘다. 남편이 함부로 하지 않는가 보다.” “가슴이 작아서 사진이 찍히려나 모르겠네.” “어린데 왜 산부인과에 왔을까?” 심지어 체모가 많은 것을 보고 “남편이 좋아했겠다”는 이야기를 들은 경우도 있었다.

“Your vagina is very pretty. Your husband wasn’t as rough as most men”; “Your breasts are so small I’m not sure they will even show in the mammogram”; ” You’re so young, why are you visiting an OBGYN?” and even, after seeing that a patient had lots of pubic hair, commenting that “Your husband must like it” are among some of the stories about doctors that respondents did provide.

환자보다 의사 중심으로 꾸며진 진료 환경에 대한 여성들의 성토도 이어졌다.

In general, respondents felt that the treatment environment was designed with doctors rather than patients in mind.

다리를 위로 향한 채 눕게 돼 있는 산부인과의 ‘진료의자’를 응답자들은 ‘굴욕의자’, ‘쩍벌의자’로 부르며 불쾌감을 표시했다. 한 여성은 “진찰대에 다리를 벌리고 올라가는 것 자체가 매우 불쾌해 다시 가고 싶지 않다”고 적었다.

(Source)

Women showed how upset they were by describing the treatment chair, in which patients lie with their legs in stirrups, as the “Chair of Shame”, or the “Spreadeagle Chair”. One woman wrote “I never want to go in that chair again. Having to spread my legs like that is very upsetting.”

자궁암 검사를 위해 병원을 찾았던 여성은 “의사가 들어오기 전 속옷을 벗고 다리를 벌린 채 준비했고 뒤이어 들어온 의사는 아무 설명도 없이 진료도구를 질 내부에 집어넣어 검사했다”고 불쾌감을 드러냈다.

Another woman who went to a hospital to be checked for cervical cancer wrote “Before the doctor came, I took off my underwear and got up and spread my legs, and when he arrived he just quickly put an instrument inside me, without any warning or explanation.”

‘진정으로 산부인과를 걱정하는 의사들 모임’의 최안나 대변인은 “산부인과 진료는 특히 예민한 분야이므로 성경험 여부 등 구체 정보가 왜 필요한지, 진료 과정은 어떻게 진행될 것인지 상세히 설명하고 의견을 구하는 건 당연한 절차”라며 “산부인과의 진료 서비스가 많이 나아지고 있다고 해도 여전히 일부 환자 눈높이에 부족한 점이 있다”고 말했다.

Choi Ahn-na, a spokesperson for the Korean Gynecological Physicians’ Association (GYNOB) [James — a notoriously anti-abortion group of OBGYNs. See here for more information about them] explained that “Gynecology and Obstetrics are very sensitive branches of medicine, for which it is both normal and essential for OBGYNs to have detailed information about patients, as this determines both the treatment type and how it’s administered. However, while OBGYNs have improved their services a great deal, it is also true that remaining weak spots need to be dealt with, as well as how things looks from patients’ perspectives.”

(Source)

여성민우회는 이달 중 1000여명에 대한 실태조사 최종 결과 분석이 끝나면 전문의·보건전문가 등과 간담회를 열어 환자를 배려하는 산부인과 의료 지침을 만들어 배포하는 등 ‘산부인과 바꾸기 프로젝트’를 이어갈 계획이다.

Continuing its “Transform OBGYN Clinics Project” [James — Yes, this is the first time it's been mentioned in the article], this month Womenlink is following-up by surveying 1000 women. After analyzing the results with health specialists, it will produce and distribute a guide for OBGYNs for dealing with patients.

김인숙 한국여성민우회 공동대표는 “왜 여성들이 산부인과에 가는 데 부담감을 느끼는지 구체적으로 확인해 앞으로 더 나은 산부인과 진료 문화를 만들어 갈 것”이라고 밝혔다.

Kim In-sook, a co-spokesperson of Womenlink, said “We will determine exactly why women feel so stressed about going to clinics, with the aim of making a better and more welcoming environment for them there.”

<한겨레>는 ‘여성이 불편한 산부인과’를 ‘여성이 행복한 산부인과’로 바꾸기 위한 제보와 의견을 받아 관련 보도를 이어갈 예정이다.

(Editor): In order to make women feel comfortable with visiting OBGYN clinics, The Hankyoreh will continue to receive and report on women’s opinions and experiences of them.